The Sterilized and Subjugated

Population Control and The Plight of Indian Women

April 15, 2015

Surgeries are hastily performed in a dirty, abandoned hospital as engrossed doctors and medical workers scurry with their unhygienic surgical instruments, barely taking the time to disinfect their tools while they hover from patient to patient the way ants scurry around crumbs. The makeshift site is brutally understaffed: there is no clean running water, and electricity is a luxury that is out of stock. Ultimately, a grand total of eighty-three sari-clad women receive surgery in a mere five hours. Their illness is their fertility. Welcome to a mass sterilization camp: an increasingly common scene in India as it attempts to combat growing population rates through sterilization drives and other controversial policies. The fight on population growth rages on amidst heated academic debates on the need for governmental population control, the ethics of human commodification, and the socioeconomic plight of Indian women.

In Chhattisgarh, one of India’s most impoverished states, eleven women died and sixty-two were hospitalized days after undergoing sterilization at the camp described. Most blamed Dr. R. K. Gupta, the man who performed the sterilization procedures, for operating with unsanitary equipment in what he knew to be substandard conditions. Gupta, in his defense, cited the post-operational drugs and painkillers distributed to the women by village medical workers as faulty and responsible for the complications they developed after the surgery. Gupta was detained by the authorities and continues to be held in custody months since the tragedy occurred as the investigation still goes on. Nonetheless, this episode is but a microcosm of a larger phenomenon that is taking place throughout India. Women are being encouraged by the government to undergo sterilization for cash in a desperate bid to curb India’s growing population, which is currently the second highest in the world at 1.25 billion people. Many women see it as a viable option, considering that there is very limited opportunity for advancement in a male-dominated society and poverty continues to afflict millions of Indian families. Furthermore, many Indian women, especially in poorer areas such as Chhattisgarh, lack any access to contraceptives, and thus treat sterilization as the ideal method of family planning.

This probes the broader question of human population control, namely, artificially altering the growth rate of a population. Concerns in this past half century regarding population growth and its effects on poverty, the environment, as well as social, political, and economic stability have led to attempts to depress fertility rates. While this can entail simple measures such as promoting reproductive education and increasing the availability of contraceptives, some nations have taken up forceful protocols to control population with China’s infamous one-child per family policy as a prominent example. However, these efforts may be in vain. Experts, such as Professor Corey Bradshaw from the University of Adelaide claim it is too late now to solely rely on short-term population control measures to keep our human society sustainable. Recent studies shows that even if a catastrophe claimed the lives of two billion people today, the world would still have a population of 8.5 billion by 2100, meaning that policies need to be enacted with a longer view. Experts say that nations should also focus on limiting consumption and designing ways to conserve environments through sustainable development and technological innovation that will allow for increased productivity in the face of decreasing land and evaporating nonrenewable resources, in addition to limiting population growth. Population control can definitely curb the growing demand on our resources but long-term conservation can only be assured if we can alter the way we harness energy and look to sustainable projects.

The tragic mishap involving the Indian sterilization camp and the underlying monetary incentives driving the process point toward another controversial phenomenon—the commodification of the human body. Society has commodifed human beings since ancient times through slavery and even cannibalism, and now contemporary cases such as funded sterilizations as well as organ, tissue, and sperm donations carry on the tradition of attributing a price to human material. This has opened new areas of discourse for professors of bioethics who have begun to contend on the morality of allowing human flesh to be price-tagged. Some view the debate through a utilitarian lens and champion the beneficial ends of such practices. Supporters of free organ trade cite the lives saved through quick and easy organ transplantation as a justification. Some laud sterilization for reducing the population growth rate. On the other hand, others are worried that such practices degrade the humanistic dignity of being. This argument highlights fears of opening the door to a society that views the individual as a mere morsel of potential capital rather than a rational agent with inherent rights. Ultimately, it is difficult to tell how the bioethical debate will shift as every day new, cutting-edge medical technologies are being discovered, tested, and produced. Furthermore, it is even more challenging to predict how governments will react to constantly evolving solutions and ethical viewpoints and translate such complexities into public policy.

And finally, we now examine the status of women in light of the sterilization tragedy. It turns out that tubal ligation, the most common method of female sterilization, costs the government three to four times as much as a male vasectomy. Vasectomies also have a much lower risk of leading to post-surgical complications and have very rarely been known to affect potency, unlike tubal ligation. Both procedures are actually about equally successful in preventing pregnancies, and yet more than one third of married Indian women undergo sterilization, compared to just one-percent of Indian men. Some blame this on cultural norms. Many Indians claim that vasectomies impact a man's virility and thus family planning programs have primarily focused on women. Furthermore, virtually all the women receiving operations in such sterilization camps come from poor backgrounds. Many are often coerced by their husbands to go through with the procedures for two critical reasons. One being that the financial compensation the woman will receive can go to supplementing her husband’s income as it is uncommon and frowned upon for women in India’s remote and rural regions to be permanent members of the workforce. And the second reason is because in the absence of widespread reproductive education and access to contraceptives, getting sterilized is seen as an effective method of preventing the household from growing and having less mouths to feed. Thus, it is apparent that there is a shocking gender imbalance in regards to how sterilization is viewed in India.

There is a shocking gender imbalance in regards to how sterilization is viewed in India.

From the need for population control in a rapidly growing country like India to the academic debate on its bioethical implications to the social plight of Indian women, it is clear that there is no single takeaway to be drawn from the Chhattisgarh sterilization deaths. Nonetheless, there are several steps that can be taken to reduce the risk of such catastrophe recurring. The Indian government must implement stricter control over sterilization procedures to ensure that surgeries are performed in safe conditions by trusted and able physicians. To make curbing population growth even more efficient, the government needs to break cultural taboos, administer access to alternate forms of birth control, incentivize men to undergo vasectomies, and provide reproductive education to the masses to dispel myths about male sterilization. These methods would structurally alter how Indian society views family planning by leveling the gender imbalance, striking at heart of the cultural taboo. And while the academic debates rage on contending the morality of subjecting humans to commodification, nations around the globe need to start taking seriously the reality of humans quickly reaching earth’s carrying capacity and implementing policies funding research for sustainable development as well as programs for family planning. These are steps that must be taken in order to create a bright future where we can avert tragedies like the one witnessed in Chhattisgarh and prevent the destruction of our environment. As Mahatma Gandhi once said, “What we are doing to the forests of the world is but a mirror reflection of what we are doing to ourselves and to one another.